title: Diet and inflammatory bowel disease: review of patient-targeted recommendations.
abstract: Patients have strong beliefs about the role of diet in the cause of inflammatory bowel disease (IBD) and in exacerbating or alleviating ongoing symptoms from IBD. The rapid increase in the incidence and prevalence of IBD in recent decades strongly suggests an environmental trigger for IBD, one of which may be dietary patterns. There are several pathways where diet may influence intestinal inflammation, such as direct dietary antigens, altering the gut microbiome, and affecting gastrointestinal permeability. However, data that altering diet can change the natural history of IBD are scarce, and evidence-based dietary guidelines for patients with IBD are lacking. Patients, therefore, seek nonmedical resources for dietary guidance, such as patient support groups and unverified sources on the Internet. The aim of this review is to identify patient-targeted dietary recommendations for IBD and to critically appraise the nutritional value of these recommendations. We review patient-targeted dietary information for IBD from structured Internet searches and popular defined diets. Patient-targeted dietary recommendations focus on food restrictions and are highly conflicting. High-quality dietary intervention studies are needed to facilitate creation of evidence-based dietary guidelines for patients with IBD.
authors.affiliation: Houston VA HSR&D Center of Excellence, Michael E. DeBakey Veterans Affairs Medical Center, Houston, Texas; Department of Medicine, Baylor College of Medicine, Houston, Texas. Electronic address: jkhou@bcm.edu.
authors.forename: Jason K
authors.initials: JK
authors.lastname: Hou
authors.affiliation: Department of Gastroenterology, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania; Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: Dale
authors.initials: D
authors.lastname: Lee
authors.affiliation: Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania, Philadelphia, Pennsylvania; Departments of Medicine and Biostatistics and Epidemiology, University of Pennsylvania, Philadelphia, Pennsylvania.
authors.forename: James
authors.initials: J
authors.lastname: Lewis
mesh_terms: D004032:Diet / Q000009:adverse effects*; D004035:Diet Therapy / Q000379:methods*; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000628:therapy*; D016896:Treatment Outcome
keywords: Crohn's Disease; Diet; FODMAP; Inflammatory Bowel Disease; Paleolithic Diet; Specific Carbohydrate Diet; Ulcerative Colitis